Gallegos-Hernández JF

Language: Spanish
References: 19
Page: 550-555
PDF size: 412.48 Kb.

ABSTRACT

Background: The upper third of the larynx shares a wall with the pharynx, the laryngopharyngeal wall. This anatomic structure is common to both organs and is often the source of epidermoid carcinomas. These carcinomas are more frequent in subjects who ingest large amounts of ethanol.
Discussion: These tumors are usually bulky, respect laryngeal function and are limited to this anatomic structure; laryngeal mobility is respected through advanced stages of the disease. The purpose of this study is to describe the indications, contraindications, technical errors and surgical technique of the supracricoid hemilaryngopharyngectomy and horizontal supraglottic laryngectomy. Because tumors originating in this region are highly lymphophilic (presenting occult nodal metastasis in up to 45%), both techniques should be accompanied by cervical lymph node dissection, generally bilateral, and including at least levels II to IV. The presence of lymph node metastases is not an absolute contraindication for these procedures.
Conclusions: We describe two surgical techniques designed to obtain adequate cancer control, preserving the natural functions of swallowing, speech and ventilation in patients with tumors arising in the supraglottic region and the region between the larynx and hypopharynx.

REFERENCES

1. Silver CE, Beiter JJ, Shaha AR, Rinaldo A, Ferlito A. Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorrhinolaryngol 2009;266:1333-1352.

2. Yüce I, Cagh S, Bayram A, Guncy E. Occult metastases from T1-T2 supraglottic carcinoma: role of primary tumor localization. Eur Arch Otorrhinolaryngol 2009;266:1301-1304.

3. Pointreau Y, Garaud P, Chapet S, Sire C, Tuchais C, Tortochaux J, et al. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J Natl Cancer Inst 2009;101:498-506.

4. Mikić A, Pendjer I, Dudvarski Z, Trivić A, Hirurgiju M. Analyses of the results in the treatments of locally advanced hypopharyngeal carcinoma with different therapeutic approach. Acta Chir Iugosl 2009;56:35-40.

5. Dietz A, Rudat V, Dreyhaupt J, Pritsch M, Hoppe F, Hagen R, et al. Induction chemotherapy with paclitaxel and cisplatin followed by radiotherapy for larynx organ preservation in advanced laryngeal and hypopharyngeal cancer offers moderate late toxicity outcome (DeLOS-Itrial). Eur Arch Otorrhinolaryngol 2009;266:1291-1300.

6. Carrasco-Llatas M, López-Mollá C, Balaguer-García R, Ferrer- Ramírez MJ, Guallart-Cómenech F, Estellés-Ferriol JE, et al. Hypopharyngeal cancer: analyses of the evolution and treatment results. Acta Otorrinolaringol Esp 2009;60:3-8.

7. Gallegos-Hernández JF, Martínez-Gómez H, Flores-Díaz R. Disección radical de cuello en el cáncer de vías aero-digestivas superiores VADS. Indicaciones, extensión y radicalidad. Cir Ciruj 2002;70:369-376.

8. Laccourreye O, Ishoo E, de Mones E, García D, Kania R, Hans S. Supracricoid hemilaryngopharyngectomy in patients with invasive squamous cell carcinoma of the pyriform sinus. I: Technique, complications and long-term functional outcome. Ann Otol Rhinol Laryngol 2005;114(1 Pt 1):25-34.

9. Kania, Hans S, García D, Brasnu D, De Mones E, Laccourreye O. Supracricoid hemilaryngopharyngectomy in patients with invasive squamous cell carcinoma of the pyriform sinus. II: Technique, complications and long-term functional outcome. Ann Otol Rhinol Laryngol 2005;114:95-104.

10. Holmes JD. Neck dissection: Nomenclature, classification and technique. Oral Maxillofac Surg Clin North Am 2008;20:459-475.

11. Patel RS, Clark JR, Gao K, O’Brien CJ. Effectiveness of selective neck dissection in the treatment of clinically positive neck. Head Neck 2008;30:1231-1236.

12. Holsinger FC, Laccourreye O, Weinstein GS, Diaz EM Jr, McWhorter AJ. Technical refinements in the supracricoid partial laryngectomy to optimize fuctional outcomes J Am Coll Surg 2005;201:809-820.

13. Gallegos-Hernández JF, Minauro-Muñoz G, Arias-Ceballos H, Hernández-Sanjuan M, Flores-Díaz R, Reséndiz-Colosia JA. Partial pharyngolaryngectomies for treatment of pharyngolaryngeal cancer. Cir Cir 2008;76:209-213.

14. Lefebvre JL, Buisset E, Coche-Dequeant B, Van JT, Prevost B, Hecquet B, et al. Epilarynx: pharynx or larynx. Head Neck 1995;17:377-381.

15. Goudakos JK, Markou K, Nikolau A, Themelis C, Vital V. Management of the clinically negative neck (N0) of supraglottic laryngeal carcinoma: a systematic review. Eur J Surg Oncol 2009;35:223-229.

16. Alonso JM. Conservative surgery of cancer of the larynx and hypopharynx. Ann Otolaryngol Chir Cervicofac 1951;68:689-696.

17. Laccourreye L, García D, Ménard M, Brasnu D, Laccourreye O, Holsinger FC. Horizontal supraglottic partial laryngectomy for selected squamous carcinoma of the vallecula. Head Neck 2008;30:756-764.

18. Lefebvre JL, Calais G. Larynx preservation, state of the art. Cancer Radiother 2005;9:37-41.

19. Moore BA, Holsinger FC, Diaz EM Jr, Weber RS. Organ-preservation laryngeal surgery in the era of chemoradiation. Curr Probl Cancer 2005;29:169-179.